The tug of war over health care drags on and on in Washington, and some days it's high comedy. Nobody knew health care could be so complicated.
But in truth, a lot about health care is complicated. We're living longer. Hooray for that, but longevity on a mass scale carries costs: for everything from joint replacement to age-related dementia.
We've found ways to cure, lessen, or prevent diseases, and hooray for that, too. But research is expensive. So are experimental drugs and prolonged treatment and delicate surgery and extensive therapy.
We can deliver babies months before full term and, thanks to science, exceptional care, and specialized hospital units, those babies not only survive but thrive. And all of that is expensive.
Who will pay the costs?
Somebody has to. And there, of course, is the problem. But that problem is complicated by a couple of other issues:
One, we don't agree on whether health care is a right or a privilege. And many political leaders apparently believe it's a privilege.
Two, we still insist on financing a lot of health care through a combination of patients' out-of-pocket payments and health insurance.
As a result, Republicans in Congress suggest letting people with no health problems go without insurance – or letting them buy insurance from a different pool than people with health problems. For many Americans, that would raise the cost of insurance well past the point of affordability.
Some presumably bright members of Congress pretend they don't understand the principle of insurance. How else do we explain Illinois Republican John Shimkus, who questioned why men should have to buy a policy that covers prenatal care?
The solution, as it has been all along, is a single-payer system, based on the principle that if we have a right to live, we have a right to health care that helps us live. And that access to vital health care shouldn't be affected by how much money we have.
With single-payer, as Cornell Professor Robert Frank explained in a New York Times column on Sunday, a public agency – the government – handles the financing of health care, but care is provided the way it is now, by private professionals, not by physicians and others who work for the government.
In his Times column, Frank (whom we interviewed on the subject in May) focused on the issue of cost. And yes, of course, paying for health care for everyone would be expensive. And yes, of course, the money to pay for it would come from taxes – more taxes than we're paying now.
But the overall cost of health care, Frank and others insist, is less under single-payer than it is now. "Substantially," Frank says. The reasons: administrative costs are lower. The expensive health-care advertising we see now is almost eliminated. And most important, says Frank, "large government entities are able to negotiate much more favorable terms with service providers."
Sunday afternoon, The Hill news site reported that support for single-payer is building among Congressional Democrats, particularly in the House, where Michigan's John Conyers has 113 co-sponsors for a single-payer bill.
Pipe dream? Sure. At the moment. It's the most liberal legislators who are behind single-payer. But the public is apparently on board.
A recent Kaiser Family Foundation poll found that 53 percent of Americans support single-payer. That's "somewhat higher" than the support Kaiser has found previously, the foundation said.
But, the foundation said, the support is "malleable." Opinions changed with the wording, and with the predictable arguments that critics would launch – "too much government control," for instance – opposition shot way up.
"Malleable support" is better than no support, though. And it seems pretty clear that most Americans believe health care is a right, not a privilege.
That message is a simple one. And it shouldn't be hard to sell – even in the age of Donald Trump, Mitch McConnell, and Paul Ryan.